Seobou, Robel O DEPARTMENT OF HEALTH OF THE CITY OF NEW YORK
N? 1 621 BUREAU OF RECORDS AND STATISTICS
BURIAL—CREMATION—TRANSPORTATION PERMIT
f t..I e'�:..:. jj'' Date -- l--- ' . ;
The Certificate olle Mg b'ie it'' t -1z�shed 0 this Department, as required by the Health Code, permission is
hereby given to NEIK 21, N. Y. .of
to remove the rema' s of__( ti '" Age _..( /Yrs Mos. ..._......_Days,
1_1,
who died at t' '4 Borough of Mallkilor
City of New York, on , 19
Burial*at* >L0-%---(_ kh:.- e' vim' , .:4..�—�_,- o �; 1 s, 19
for
�y
144.
This permit must be banded to the Keeper pry 1
of the Cemetery or Crematory by the7 )1te, s �"M
Funeral Director in charge of the funeral. Boro>� stray
4'%.
*Cross out one. Per
,4-e7
1HH-34.SM-702239(62) 447 /
Crematory*
Record by Cemetery* Representative
Cremation �,
Date of Burial* r.• Cr1��t��'=,
Location f
*
Cross out one. Sign ture.
EXTRACTS FROM EW YORK CITY
HEALT CODE
SECTION 205.17 Remains of persons dying in the City shall
,be buried, cremated or transported out of the City within four
days following death or fetal death. Such remains may, however,
within the four day period,be placed in the general reception vault
of a cemetery for a period not exceeding,ten days from the
placement therein. The Department may extend the time limita-
tions contained in this section and may, in granting an extension,
specify conditions to be observed to prevent seepage or escape of
offensive odors.
SECTION 205.23 No person shall remove human remains
from the place of death or fetal death unless a removal permit
has been issued by the Department or authorization to remove
has been granted by telephone or unless a burial, cremation or
transportation permit has been issued pursuant to section 205.25.
SECTION 205.25 (a) When a death or fetal death occurs
in the City, the remains shall not be buried, cremated or trans-
ported out of the City unless an appropriate permit has'been issued
by the Department. Such permit shall not be issued until a cer-
tificate of death or fetal death and, if required, a confidential
medical report have been filed with the Department. A permit to
bury or cremate human remains or to transport them out of the
City includes authorization to remove the remains from the place
of death or fetal death pursuant to section 205.23(a). If remains
are to be transported out of the City by common carrier, they
shall be prepared in such,manner as to comply with the State
Sanitary Code.
(b) No person in charge of a cemetery or crematory in 'the
City shall allow human remains to be buried or cremated in the
cemetery or crematory until a permit issued pursuant to sub-
section (a) of this section is surrendered to him, and he shall not
accept any permit which has been changed or altered unless the
change or alteration is countersigned by the Department. A
permit for the burial or cremation of human remains issued by the
authorized agency of any municipality or county within the United.
States, of any state, territory, or possession of the United States,
the District of Columbia,or of any foreign state within whose ju-
risdiction the death or fetal death occurred, which specifies the
cemetery or crematory, may be accepted by the person in charge
of the cemetery or crematory instead of a permit issued by the
Department. If a permit issued in another jurisdiction does not
specify the cemetery or crematory,or if the cemetery or crematory
specified is not the actual place of'intended burial or cremation,
it,shall not be accepted by the person in charge of a cemetery or
crematory but shall be exchanged for a permit issued by the office
of the Department in the borough of entry of the remains. The
person in charge of a cemetery or crematory shall maintain a per-
manent file of all permits received pursuant to this subsection and
shall report to the Department such information regarding the
receipt and burial or cremation of human remains as the De-
partment may require.
(c) A burial permit issued pursuant to this-section includes
authorization to place the remains in the general reception vault
of the cemetery named in the permit prior to permanent burial
in such cemetery.
SECTION 205.27 Human remains shall not be 'brought into
the.City unless a permit for their transportation,burial or crema-
tion has.been•issued by the authorized agency of a municipality
or county within the United States, of a state, territory or pos-
session of the United States,: the District of Columbia or of any
foreign state within 'whose jurisdiction death or fetal death'
occurred. Remains brought into the City for burial or cremation
shall be dealt with pursuant to section 205.17 and section 205.25.
Remains brought into the City in the course of transit shall not
be detained for any purpose other than transshipment unless a
permit is first obtained from the Department specifying where,
how long and under what conditions such remains may be held,
but no such permit shall be required for the uninterrupted transit
or for the direct transshipment of remains. This section does not
apply to the transportation of human tissues to be used for diag-
nostic purposes or pathological study.